COMBAT LIFE SAVING

Question 1

Shock can be the result of

Answer 1

a significant blood loss, heart failure, severe and painful blows to the body, burns, severe wounds that become infected, a severe allergic reaction to drugs or certain foods, certain insect bites, snakebites, or dehydration.

Question 2

What are Signs and Symptoms of Shock

Answer 2

 Sweaty but cool skin.
 Pale skin.
 Restlessness, nervousness.
 Thirst.
 Loss of blood (caused by internal or external bleeding).
 Confusion or loss of awareness.
 Faster than normal breathing rate.
 Blotchy or bluish skin (especially around the mouth and lips).
 Nausea and vomiting.

Question 3

The body can bleed out in how many seconds

Answer 3

60-120 seconds

Question 4

The causes of hemorrhagic shock are

Answer 4

external loss of whole blood, an internal hemorrhage or an extreme loss of plasma due to severe burns.

Question 5

In the field, the procedures followed to treat for shock are identical to

Answer 5

procedures that would be performed to prevent shock

Question 6

How to treat for shock

Answer 6

 Move the casualty to cover if the situation requires and permits.
 Position the casualty on his or her back. Do not move the casualty or his or her limbs if suspected fractures have not been splinted.
 Elevate the casualty’s feet higher than the level of the heart.
 Loosen clothing at the neck, waist or wherever it may be binding
 Prevent chilling or overheating
 Calm the casualty
 During the treatment or prevention of shock, do not give the casualty any food or drink. If the casualty is unconscious, turn his or her head to the side so that, in case he or she vomits, the victim will not choke on the vomit.

Question 7

What are two types of soft tissue injuries

Answer 7

closed wounds (in which the skin is not broken) and open wounds (in which the skin is broken.)

Question 8

Closed wounds are commonly caused by

Answer 8

blunt objects striking the body with sufficient force to crush the tissues beneath the skin

Question 9

Contusions are characterized by

Answer 9

swelling and pain, caused by the blood leaking into the wound. This “leaking blood” will cause the characteristic black and blue marks

Question 10

An open wound is any wound in which

Answer 10

the surface of the skin has been broken

Question 11

Open wounds may be classified as

Answer 11

abrasions, lacerations, incisions, or puncture wounds

Question 12

What is an abrasion

Answer 12

abrasion is a loss of a portion of the epidermis and part of the dermas from its being rubbed or scraped across a hard surface. It is extremely painful, and blood may ooze from injured capillary vessels at the surface. It does not penetrate completely through the skin.

Question 13

What is a laceration

Answer 13

A laceration is a cut produced by glass, metal, or any other object that may leave a jagged wound on the skin surface and cut through the subcutaneous tissue, the underlying muscles, associated nerves, and blood vessels

Question 14

What is an incision

Answer 14

An incision is similar to a laceration, except that the wound will be somewhat “cleaner,” having no jagged edges

Question 15

Puncture wounds may result from what

Answer 15

a stab with a knife, nail, ice pick, splinter, or any other pointed object. They may also result from gunshot injuries

Question 16

Treatment of Open Wounds is

Answer 16

 Control the bleeding by direct pressure, pressure points, or as a last resort, a tourniquet.
 Prevent contamination with a sterile dressing.
 Aside from serious blood loss, the danger of infection from an open wound should be your principal concern. The field dressing carried by every Marine in the field consists of two parts: a sterile dressing and a bandage to hold the dressing snugly in place
 When direct pressure is not required, do not apply the bandage too tightly, as the blood supply to the lower extremities may be restricted.
 Do not apply the bandage too loosely (the most common error), because it will not hold the dressing in place. The bandage must be applied snugly, as it will stretch over time.
 When bandaging extremities, leave fingers and toes exposed so that color changes may be noted. Pain, pale skin, numbness and tingling all indicate poor circulation, potentially due to constricting bandages.
 Immobilize and elevate the injured part in the event of serious bleeding, providing it will not aggravate other injuries. (Procedures on immobilization will be covered in follow-on instruction).

Question 17

Types of Special wounds are

Answer 17

avulsions, crushing wounds, and amputations

Question 18

An avulsion is what

Answer 18

an injury in which a whole piece of skin with varying portions of tissue or muscle is either torn loose completely or left hanging as a flap.

Question 19

Crushing wounds are what

Answer 19

contusions that are more severe, as the underlying skeletal support is also damaged. Crushing wounds may or may not be characterized by open skin.

Question 20

Traumatic amputations may be caused by what

Answer 20

explosions, sharp objects, or by separations. An amputation is characterized by the separation of either digits (fingers, toes, etc.) or limbs from the victim’s body.

Question 21

The primary symptom of an open or “sucking” chest wound is

Answer 21

a hole in the chest wall

Question 22

Symptoms of an Open Chest Wound are

Answer 22

 Pain at the site of the injury.
 Pain that is aggravated by or occurs with breathing, localized around the site of an injury in the chest.
 Dyspnea (difficulty or pain with breathing).
 Failure of one or both sides of the chest to expand normally when inhaling.
 A rapid, weak pulse and low blood pressure.
 Cyanosis (discoloration) of the lips, fingertips, or fingernails

Question 23

Treatment of an Open Chest wound is

Answer 23

 Use a field dressing plastic wrapper.
 Tear open one end of the plastic wrapper covering the field dressing. Be careful not to destroy the wrapper.
 Remove the inner packet (field dressing).
 Tear open the empty plastic wrapper and create a flat surface, using as much of the wrapper as possible.
 Place wrapper over wound. Place the inside surface of the plastic wrapper directly over the open chest wound as the casualty exhales and hold in place.
 Apply dressing to the wound.
 Using the free hand, shake open the field dressing and place the white side of the dressing directly over the plastic wrapper covering the open wound, holding it securely in place to create an airtight dressing.
 Place casualty on injured side. Position the casualty on his injured side or in a sitting position, whichever makes breathing easier.
 Make the victim warm and evacuate as soon as possible.

Question 24

Once a casualty is treated for an open chest wound, a condition known as what may develop

Answer 24

tension pneumothorax

Question 25

Tension pneumothorax is the 2nd leading cause of what

Answer 25

preventable death on the battlefield

Question 26

If you see the casualty’s condition worsen for no apparent reason from an open chest wound you should do this immidiately

Answer 26

unplug the seal immediately

Question 27

What are Three Types of Bleeding

Answer 27

arterial, venous, and capillary

Question 28

Arterial bleeding is characterized by what

Answer 28

the flow of bright red blood (due to the oxygen content) that pumps out in distinct spurts. The flow can be alarmingly profuse

Question 29

Severe arterial bleeding could cause a victim to bleed to death in how many minutes

Answer 29

two to three minutes or less depending on the location of the wound

Question 30

Venous bleeding is characterized by what

Answer 30

a steady flow of dark red or maroon-colored blood. Although veinal bleeding may be profuse, it is much easier to control than arterial bleeding

Question 31

Capillary bleeding is characterized by what

Answer 31

the slow oozing of blood, usually from minor wounds. Because of the large amount of surface area that may be involved, the threat of contamination may be more serious than blood loss

Question 32

Mild Bleeding may be controlled by both elevating the wound and by the application of

Answer 32

direct pressure

Question 33

This is the single most effective method for stopping serious bleeding.

Answer 33

Direct pressure on the wound

Question 34

What is a pressure point

Answer 34

A pressure point is a location where the main artery to the injury site lies near the surface of the skin and directly over a bone. There are twenty-two pressure points throughout the body. The three most effective pressure points are over the brachial (arm), femoral (upper thigh), and carotid (neck) arteries

Question 35

If casualty is suffering from life-threatening hemorrhaging, do not hesitate to apply this

Answer 35

tourniquet

Question 36

haemostatic agents can be a very effective method of what

Answer 36

stopping life-threatening hemorrhaging if used correctly

Question 37

QuikClot works by causing what

Answer 37

a chemical reaction that rapidly absorbs liquid from the blood by creating hydrogen bonds that quickly generate intense heat. That chemical reaction will occur with any liquid or tissue it comes in contact with. By absorbing the liquid from blood, Quikclot concentrates the clotting factors and encourages rapid clotting to stop the bleeding

Question 38

The HemCon bandage is a

Answer 38

firm 4X4 inch dressing that is sterile and individually packaged. HemCon like QuickClot uses a chemical reaction to induce blood clotting, but HemCon does not extract hydration through extraction.

Question 39

Combat Gauze is

Answer 39

an advanced haemostatic agent combined with the simplicity of gauze.It can also be applied anywhere on the body where there is a life-threatening bleed—will not effect organs, face, eyes, or groin area.

Question 40

Tourniquet Application Steps are

Answer 40

 Select a place between the wound and the heart, approximate 2 inches from the wound.
 Place a pad, made from a dressing or other suitable material, over the main artery supplying blood to the limb.
 Apply a constricting band over the pad, knot it and insert a device to tighten the tourniquet. Ropes, pieces of wire or other thin materials should not be used because they could cut into the tissues of the limb.
 Tighten the tourniquet just enough to control the bleeding. If it is unnecessarily tight, it will cause excessive damage to the limb.
 Mark the casualty’s forehead with “T” and the time and date the tourniquet was applied FOR EACH TOURNIQUET APPLIED

Question 41

Tourniquet Application Considerations are

Answer 41

 Only the absolute minimum of clothing should be removed.
 If the casualty needs to be moved, a tourniquet that is self-applied by the casualty is the most reasonable initial choice to stop major bleeding.
 Never place tourniquet on a joint.
 Do not cover tourniquet under any conditions. Leave it exposed for open viewing.
 All Marines engaged in combat missions should have a suitable tourniquet readily available at a standard location on their battle gear and be trained in its use

Question 42

Common Tourniquet Mistakes are

Answer 42

 Not using one when you should.
 Using one when not appropriate.
 Putting it too close to wound.
 Not applied tightly enough.

Question 43

A casualty can lose one to three pints of blood, internally, from a broken

Answer 43

femur (thighbone) or pelvis

Question 44

Symptoms of Internal Bleeding

Answer 44

 Rapid and weak pulse.
 Pale, moist and cold skin.
 Shallow and rapid respiration.
 Thirst.
 Dilated pupils.
 Coughing up or vomiting dark red blood the color of coffee grounds.
 Stiff abdominal muscles.

Question 45

Treatment for Internal Bleeding is

Answer 45

 Treat for shock.
 Give nothing by mouth.
 Evacuate as soon as possible.

Question 46

Abdominal Wound Symptoms are

Answer 46

 Nausea and vomiting are good indications of abdominal injury, especially if the vomitus contains blood.
 Pain, although usually minimal in the abdomen.
 Tenderness exists in affected areas.
 Muscle spasms or a stiffening of the abdominal muscles suggests the irritation of the lining of the abdominal cavity.
 Shock.
 Bruises and Abrasions

Question 47

Treatment for Abdominal Wounds is

Answer 47

 Position the casualty on his or her back with the knees flexed up to relieve pressure on the muscles of the abdomen.
 Expose the wound. Remove loose clothing from the wound, leaving clothing that is stuck in place.
 With a clean, moist dressing, gently pick up any organs that may be on the ground. Place the organs on top of the casualty’s abdomen. DO NOT attempt to replace any protruding organs.
 Apply moist field dressing
 Grasp tails of dressing with two hands.
 Hold dressing directly over wound with white side down. Pull dressing open and place directly over wound.
 With one hand, hold dressing in place and use the other hand to wrap one of the tails around the body.
 Wrap the other tail in the opposite direction until the dressing is completely covered.
 Tie the tails with the knot at the patient’s side.
 Treat for shock and evacuate as soon as possible

Question 48

Classification of burns

Answer 48

Burns are classified in degrees, i.e. First, Second and Third

Question 49

First- Degree burn characteristics

Answer 49

result only in reddening of the skin

Question 50

Second -degree burn characteristics

Answer 50

characteristically result in blisters forming on the skin

Question 51

Third-degree burns appear

Answer 51

the skin may appear pale, dry, and white or it may be brown or charred. Clotted blood vessels may be seen through the skin and occasionally the bone structure is exposed. With third degree burns, the nerve endings in the skin are usually destroyed, and the victim will feel no pain.

Question 52

Three Types of Burns are

Answer 52

Thermal
Electrical
Chemical

Question 53

Thermal burns are caused by

Answer 53

contact with fire, hot objects, hot liquids, gases, or nuclear blast or fireball. This is the most frequent type of burn in a combat environment

Question 54

Electrical burns are caused by

Answer 54

contact with electrical wires, current, or lightning

Question 55

Chemical burns are caused by

Answer 55

contact with wet or dry chemicals or white phosphorus (from marking rounds and grenades). Chemical burns require special treatment in that the chemical must be removed for the burning to stop.

Question 56

Treatment for Burns are

Answer 56

 Remove the casualty from the source of the burn.
 Remove and cover the thermal burn casualty with a field jacket or any large non-synthetic material and roll him or her on the ground to smother (put out) the flames.
 Remove electrical burn casualties from the electrical source by using any nonconductive material, such as rope, clothing, or dry wood. DO NOT touch the casualty with your bare hands.
 Remove chemical burn casualties from the chemicals.
 Remove liquid chemicals by flushing with as much water as possible.
 Remove dry chemicals by brushing off loose particles and then flushing with large amounts of water, if available.
 Remove white phosphorus (WP) from the skin by brushing with a damp cloth or scraping with a knife.

Question 57

For FIRST and SECOND degree burns with closed blisters ONLY treatment is

Answer 57

 Immerse the burned part in cold water for two to five minutes if the patient is seen within fifteen minutes of the time of injury and the burn involves less than 20% of the total body surface.
 Cover the burn with a moist, sterile dressing.
 Do not puncture the blisters on second-degree burns.
 DO NOT APPLY CREAMS OR OINTMENTS!
 Transport the patient promptly to a medical facility

Question 58

For THIRD degree burns or SECOND-degree burns with open blisters treatment is

Answer 58

 Examine for and relieve any respiratory distress. Always anticipate respiratory difficulty when there are burns about the face and neck or when the patient has been exposed to hot gases or smoke. Stand by to administer CPR.
 Cover the burned area with a dry sterile dressing or a clean sheet.
 Treat the patient for shock if it is present, and make him as comfortable as possible.
 DO NOT APPLY CREAMS OR OINTMENTS!
 Transport the patient promptly to the nearest medical facility

Question 59

What are Fractures

Answer 59

the sudden breaking of a bone or a break in a bone

Question 60

2 Types of Fractures are

Answer 60

closed fractures (in which the skin is not broken) and open fractures (in which the skin is broken.)

Question 61

Symptoms of Fractures are

Answer 61

loss of movement, pain with acute tenderness over the site of the fracture, swelling and bruising, deformity or possible shortening, unnatural mobility, or crepitus or grating that is heard when the ends of the bone rub together

Question 62

Treatment of fractures are

Answer 62

 Stop the bleeding if required.
 Remove all binding objects.
 “Splint them where they lie.”
 Immobilize the joint above and below the break.
 Use padding.
 Tie/secure the splint.
 Use a sling if applicable.
 Check for circulation.

Question 63

Symptoms of Spinal Injuries are

Answer 63

 Pain in the neck or back.
 Numbness or tingling in the extremities.
 Deformity.
 Paralysis.

Question 64

Treatment of Spinal Injuries are

Answer 64

 Stop the bleeding if required.
 Insure that the airway is secure and that circulation is stable.
 Immobilize the casualty. Use a back board if available.
 Treat for shock.